scholarly journals Antibiotics using in Georgia: clinical and epidemiological features

2020 ◽  
pp. 46-46
Author(s):  
I. Korinteli ◽  
M. Javakhadze ◽  
K. Pagava
Keyword(s):  
Infectious Disease ◽  
Antibiotic Therapy ◽  
Clinical Research ◽  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Hospital Setting ◽  
Clinical Aspects ◽  
Actual Problem ◽  
Defined Daily Doses ◽  
Georgian Population

Background. High incidence and lethality of infectious disease is an actual problem of the 21st century medicine. Infectious diseases are one of the most common causes of morbidity worldwide. Untreatable bacterial infections with the current available antibiotics lead to increased morbidity and mortality. Antimicrobials are the most commonly prescribed drugs in the community and hospital setting. However, inappropriate use of antibiotics in recent years has particularly increased the number of antibiotic-resistant strains. Antimicrobial resistance is a significant global health threat. Without effective antimicrobials, much of the progress made in fighting infectious disease would be lost. The recent rise in resistance to these critical medicines is therefore extremely worrisome. Objective. To study epidemiological and clinical aspects of antibiotics using in Georgia. Materials and methods. The study was retrospective-prospective. We used ATC/DDD methodology for epidemiological research of antibiotic using in the country and it held 2011-2019. According to this methodology, we calculate defined daily doses of antibiotics per 1000 inhibitors (DID). The point prevalence survey was performed in 2017-2019 in Georgian hospitals for clinical research. Results and discussion. In last year increased antibiotic using in Georgian population. The lowest rate was in 2014 (19 DID) and the highest in 2019 (37 DID). The most commonly used antibiotics in Georgia are ceftriaxone, amoxicillin / clavulanic acid, azithromycin and ciprofloxacin. Frequency of antibiotic treatment in Georgian hospitals ranges between 77.6 % (2017) and 86.1 % (2019). The use of third generation cephalosporin ranges between 61.9 % (2017) and 59.6 % (2019). From the clinical aspects of antibiotic therapy, it is noteworthy that prevalence of antibiotic using in Georgian clinics is high and ranged from 77.6 % (2017) to 86.1 % (2019). Antibacterial prophylactic decreased and ranged from 38.3 % (2017) to 20.3 % (2019). Antibiotic selection according to guidelines on the most frequent nosology ranges between 73.8 % (2017) and 69.2 % (2019). Empirical antibiotic therapy decreased in last years and ranges between 92.2 % (2017) and 69.2 % (2019). Conclusions. Increasing rate of antibiotic using in Georgian population and high use of broad-spectrum antibiotics in remarkable. In hospitals, antibiotics are prescribing according to the national or intra hospital guidelines, but there prevalence rate is high. Patient histories included information about general criteria of starting antibiotic therapy. Stop or review date of antibiotic treatment after 72 h in poorly presented. We think that it is very important to continue epidemiological and clinical research for future. Also update or developed new guidelines will be perfect way for optimization.

Underestimated Collateral Effects of Antibiotic Therapy in Prosthesis-Associated Bacterial Infections

2007 ◽  
Vol 30 (9) ◽  
pp. 786-791 ◽  
Author(s):  
L. Baldassarri ◽  
L. Montanaro ◽  
R. Creti ◽  
C. R. Arciola
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Virulence Factors ◽  
Medical Devices ◽  
Bacterial Infections ◽  
Bacterial Virulence ◽  
The Other ◽  
Aggressive Therapy ◽  
Collateral Effects ◽  
Stimulation Of

Antibiotic treatment of infections associated with the use of indwelling medical devices in ageing and/or severely ill patients represents a significant healthcare problem due to the difficulty of treating such infections and to the various collateral effects that may be observed following the often aggressive therapy We summarize some effects of antibiotics on the expression of virulence factors of the microorganisms which cause such infections. These effects, particularly those resulting in a stimulation of bacterial virulence, might be usefully included among the other well-known collateral effects of antibiotic therapy

scholarly journals Therapeutic Efficacy of Bacteriophages

2021 ◽  
Author(s):  
Ramasamy Palaniappan ◽  
Govindan Dayanithi
Keyword(s):  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Bacterial Infections ◽  
Bacterial Species ◽  
Resistant Bacteria ◽  
Drug Resistant ◽  
Bacteriophage Therapy ◽  
Drug Resistant Bacteria

Bacteriophages are bacterial cell-borne viruses that act as natural bacteria killers and they have been identified as therapeutic antibacterial agents. Bacteriophage therapy is a bacterial disease medication that is given to humans after a diagnosis of the disease to prevent and manage a number of bacterial infections. The ability of phage to invade and destroy their target bacterial host cells determines the efficacy of bacteriophage therapy. Bacteriophage therapy, which can be specific or nonspecific and can include a single phage or a cocktail of phages, is a safe treatment choice for antibiotic-resistant and recurrent bacterial infections after antibiotics have failed. A therapy is a cure for health problems, which is administered after the diagnosis of the diseases in the patient. Such non-antibiotic treatment approaches for drug-resistant bacteria are thought to be a promising new alternative to antibiotic therapy and vaccination. The occurrence, biology, morphology, infectivity, lysogenic and lytic behaviours, efficacy, and mechanisms of bacteriophages’ therapeutic potentials for control and treatment of multidrug-resistant/sensitive bacterial infections are discussed. Isolation, long-term storage and recovery of lytic bacteriophages, bioassays, in vivo and in vitro experiments, and bacteriophage therapy validation are all identified. Holins, endolysins, ectolysins, and bacteriocins are bacteriophage antibacterial enzymes that are specific. Endolysins cause the target bacterium to lyse instantly, and hence their therapeutic potential has been explored in “Endolysin therapy.” Endolysins have a high degree of biochemical variability, with certain lysins having a wider bactericidal function than antibiotics, while their bactericidal activities are far narrower. Bacteriophage recombinant lysins (chimeric streptococcal–staphylococcal constructs) have high specificity for a single bacterial species, killing only that species (lysin (CF-301) is focused to kill methicillin resistant Staphylococcus aureus (MRSA)), while other lysins have a broader lytic activity, killing several different bacterial species and hence the range of bactericidal activity. New advances in medicine, food safety, agriculture, and biotechnology demonstrate molecular engineering, such as the optimization of endolysins for particular applications. Small molecule antibiotics are replaced by lysins. The chapter discusses the occurrences of lytic phage in pathogenic bacteria in animals and humans, as well as the possible therapeutic effects of endolysins-bacteriophage therapy in vivo and in vitro, demonstrating the utility and efficacy of the therapy. Further developments in the bacteriophage assay, unique molecular-phage therapy, or a cocktail of phage for the control of a broad range of drug-resistant bacteria-host systems can promote non-antibiotic treatment methods as a viable alternative to conventional antibiotic therapy.

Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

2019 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Attabak Toofani Milani ◽  
Mahshid Mohammadian ◽  
Sadegh Rostaminasab ◽  
Roghayeh Paribananaem ◽  
Zohre Ahmadi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Diagnostic Test ◽  
Bacterial Infections ◽  
Intervention Studies ◽  
Antibiotic Use ◽  
Clinical Suspicion ◽  
Diagnostic Biomarker ◽  
Clinical Routine ◽  
Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

scholarly journals Laparoscopic appendectomy versus antibiotic treatment for acute appendicitis—a systematic review

2021 ◽  
Author(s):  
Franziska Köhler ◽  
Anne Hendricks ◽  
Carolin Kastner ◽  
Sophie Müller ◽  
Kevin Boerner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antibiotic Therapy ◽  
Antibiotic Treatment ◽  
Laparoscopic Appendectomy ◽  
Data Extraction ◽  
Open Appendectomy ◽  
Cochrane Library ◽  
Pubmed Database ◽  
Uncomplicated Appendicitis ◽  
Absence From Work

Abstract Background Over the last years, laparoscopic appendectomy has progressively replaced open appendectomy and become the current gold standard treatment for suspected, uncomplicated appendicitis. At the same time, though, it is an ongoing discussion that antibiotic therapy can be an equivalent treatment for patients with uncomplicated appendicitis. The aim of this systematic review was to determine the safety and efficacy of antibiotic therapy and compare it to the laparoscopic appendectomy for acute, uncomplicated appendicitis. Methods The PubMed database, Embase database, and Cochrane library were scanned for studies comparing laparoscopic appendectomy with antibiotic treatment. Two independent reviewers performed the study selection and data extraction. The primary endpoint was defined as successful treatment of appendicitis. Secondary endpoints were pain intensity, duration of hospitalization, absence from work, and incidence of complications. Results No studies were found that exclusively compared laparoscopic appendectomy with antibiotic treatment for acute, uncomplicated appendicitis. Conclusions To date, there are no studies comparing antibiotic treatment to laparoscopic appendectomy for patients with acute uncomplicated appendicitis, thus emphasizing the lack of evidence and need for further investigation.

scholarly journals Thalamic abscess in a patient with hereditary hemorrhagic telangiectasia successfully treated with an empiric antibiotic regime: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xavier A. Santander ◽  
Anwar Saab ◽  
Juan Manuel Revuelta-Barbero ◽  
Elena Múñez
Keyword(s):  
Antibiotic Treatment ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Diagnostic Yield ◽  
Neurological Complications ◽  
Clinical Aspects ◽  
Complete Disappearance ◽  
Empiric Antibiotic ◽  
Dominant Disease ◽  
Antibiotic Regime ◽  
Stereotaxic Biopsy

Abstract Background Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disease associated with neurological complications, including cerebral abscesses (CA). They tend to be unique, supratentorial and lobar. While the surgical intervention is a rule of thumb when treating and diagnosing the etiology of these lesions, this is not always possible due to dangerous or inaccessible locations. We report the case of a patient solely treated with empiric antibiotics without stereotaxic intervention and satisfactory results. Case presentation We present the case of a 21-year-old patient with a right thalamic abscess due to HHT and pulmonary arteriovenous malformations, previously embolized, treated solely with antibiotics. At first, we contemplated the possibility of a stereotaxic biopsy, but the high-risk location and the fact that our patient received a previous full course of antibiotic treatment (in another center), made us discard this intervention because of the low diagnostic yield. We started an empiric antibiotic regime. We followed up very closely the clinical and radiological evaluation the next weeks, adjusting our antibiotic treatment when necessary. The results were favorable from both the radiological and clinical aspects and 6 months after the diagnosis the images show its almost complete disappearance. Conclusion Carefully tailored antibiotic-only regime and vigilance of its adverse effects and close radiological following is a good treatment approach when surgery is not an option.

scholarly journals Adolescents and primary herpetic gingivostomatitis: an Italian overview

2021 ◽  
Author(s):  
Elena Bardellini ◽  
Francesca Amadori ◽  
Federica Veneri ◽  
Giulio Conti ◽  
Alberto Paderno ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Antibiotic Therapy ◽  
Medical Records ◽  
Bacterial Infections ◽  
Group A ◽  
Acid Gel ◽  
Herpetic Gingivostomatitis ◽  
Group B ◽  
Italian Adolescents ◽  
Hyaluronic Acid Gel

Abstract Aim The aim of this study was to investigate the therapies administered to Italian adolescents with primary herpetic gingivostomatitis (PHGS) Methods The medical records of 74 adolescents with PHSG were reviewed. The following data were recorded: age, gender, day of onset, type of treatment, lesions’ severity, pain scoring, eating, and drinking ability. The oral examination was performed at the first evaluation (T0) and after one week (T1). Results All patients showed up at the first visit at least 48 h after the onset of symptoms. No patient was prescribed an antiviral therapy. An antibiotic therapy was prescribed in order to prevent secondary bacterial infections. Fifteen patients had been treated with non alcoholic chlorhexidine rinses (group A), 29 patients with non alcoholic chlorhexidine rinses plus hyaluronic acid gel (group B); 30 patients with non alcoholic chlorhexidine rinses plus Mucosyte® (group C). A significant improvement of the pain scoring and lesions’ severity was noted in group C. Conclusion In Italian adolescents, PHGS is diagnosed at least 48 h after onset and the antibiotic therapy is widely prescribed in order to prevent overinfections. Among topical therapies, an association of verbascoside and sodium hyaluronhate seems to favour a faster healing.

scholarly journals Visceral Mycotic Aneurysm: Superior Mesenteric Artery Aneurysm Caused by K. pneumoniae

2021 ◽  
pp. 1-4
Author(s):  
Reham Almasoud ◽  
Alaaeddin Nwilati ◽  
Saeb Bayazid ◽  
Mamoun Shafaamri
Keyword(s):  
Infectious Disease ◽  
Antibiotic Therapy ◽  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Mycotic Aneurysm ◽  
Artery Aneurysm ◽  
Management Plan ◽  
Resected Tissue ◽  
Infectious Disease Specialists

We herein report a rare case of mycotic aneurysm of the superior mesenteric artery caused by <i>Klebsiella pneumoniae</i>. A 66-year-old man, a known case of hypertension and aorto-oesophageal fistula with stented aorta in 2010 and 2018, presented to the emergency department multiple times over 2 months with severe postprandial abdominal pain associated with vomiting and fever. On his last presentation, the obtained blood cultures grew ESBL positive <i>K. pneumoniae</i> and a repeated computed tomography (CT) showed a growing aneurysm at the origin of the ileocecal branch of the superior mesenteric artery measuring 17 × 10 mm (the aneurysm was 8 × 7.5 mm in the CT angiography on the previous admission). Extensive workup did not reveal the underlying cause of the mycotic aneurysm, thus we believe the cause to be the infected aortic stent, leading to bacteraemia and vegetations to the mesenteric artery causing the aneurysm. The management plan was placed by a multidisciplinary team consisting of vascular surgeons and infectious disease specialists along with review from a dietician to evaluate the patient’s nutritional status. The patient was started on total parenteral nutrition due to his postprandial pain and on antibiotic therapy according to the infectious disease team’s recommendation. He underwent surgical resection of the mycotic aneurysm, which showed a thrombosed aneurysm in the jejunoileal mesenteric area. The histopathology of the resected tissue demonstrated inflammatory aneurysm of the mesenteric artery. Following the surgery, the patient continued his antibiotic therapy and was discharged on the 13th post-operative day with follow-up appointments in the vascular surgery and infectious disease clinic.

Therapeutic possibilities of Bothrops jararaca in high dilution

2021 ◽  
Vol 10 (36) ◽  
pp. 215-217
Author(s):  
Eduardo Costa Gaia Nazareth ◽  
Francisco José De Freitas
Keyword(s):  
Bacterial Infections ◽  
Complement C3 ◽  
Clinical Aspects ◽  
High Dilution ◽  
Complement Components ◽  
Physical Description ◽  
Bothrops Jararaca ◽  
High Dilutions ◽  
The Many ◽  
Therapeutic Possibilities

Introduction: The knowledge and use of the venom of Bothrops jararaca in high dilutions is still quite limited. One of the important properties is the use of one of its components, bradykinin, for the development of antihypertensive medication known as captopril. Other situations, such as clinical, local and systemic should receive more depth to the composition of Materia Medica related to various medical actions on the man and mammals in general. The systemic action of the bite of this snake, includes hemostasis disorders, culminating as bleeding gums, in addition to sweating, hypertension, and hypothermia. The action includes local pain and swelling with bruising, bleeding and often blistering and tissue necrosis. The action on the immune system, through action on the complement C3 and other complement components may show its possible use in cases of bacterial infections, including mycobacteria, as presented in the study of 1970 Vanessa Birdsey, "Interactions of poisons toxic with the addition, "the journal of Immunology 1971. Today, this poison has a toxicology published by Anibal Melgarejo, "Venomous Animals of Brazil", 2003, which subsidizes the development of study for its use in high dilutions, and a comprehensive study of the biology of the animal itself. Published studies on biomolecular analysis add more details about the relations of the poison and mammals. All these characteristics suggest the use of poison as a homeopathic remedy. Objective: To investigate the therapeutic possibilities in high dilutions of the venom of the snake Bothrops jararaca, expanding its clinical use. Methodology: Methodological description of this poison in contemporary bases including: Origin, physical description chemistry, toxicology, pharmacology and medicine in preparation of high dilution, general action, specific actions on systems or organs, sensations, modalities, concomitants, etiological indications relations main clinics. Results: Defining the therapeutic indications such as modulation of the complement system, action on the cardiovascular system, among other uses, by Bothrops jararaca in high dilution. Conclusion: This evaluation can be used for different sources of products and allows the rational use of Bothrops jararaca in high dilution. The results can and should be complemented by clinical studies and pathogenetic. Bacterial infectious diseases such as tuberculosis and leprosy, and autoimmune disease LES and may receive treatment studies with the drug based on Bothrops jararaca snake venom because they are indirectly associated with them via similarity of the failure of complement, an important marker for bacterial the defense of mammals. Action on clinical aspects like hypertension, sweating, hypothermia and necrosis shall be seen. Perhaps the search for the stimulation of complement show a new pathway for the harmonization, long-predicted by Hahnemann, Hering and searched for among the many that followed the creator of this therapy.

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